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Pan Y, Xiao Y. Language and executive function in Mandarin-speaking deaf and hard-of-hearing children aged 3-5. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024:enae037. [PMID: 39277795 DOI: 10.1093/jdsade/enae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 08/09/2024] [Accepted: 08/27/2024] [Indexed: 09/17/2024]
Abstract
The study aimed to explore spoken language and executive function (EF) characteristics in 3-5-year-old prelingually deaf and hard-of-hearing (DHH) children, and evaluate the impact of demographic variables and EF on spoken language skills. 48 DHH children and 48 typically developing children who use auditory-oral communication were recruited. All participants underwent EF tests, including auditory working memory (WM), inhibitory control, cognitive flexibility, and the EF performance reported by parents. Using Mandarin Clinical Evaluation of Language for Preschoolers (MCELP), vocabulary comprehension, sentence comprehension, vocabulary naming, sentence structure imitation, and story narration were evaluated only in the DHH group, and their results were compared with the typical developmental level provided by MCELP. Results showed that DHH children exhibit deficiencies in different spoken language domains and EF components. While the spoken language skills of DHH children tend to improve as they age, a growing proportion of individuals fail to reach the typical developmental level. The spoken language ability in DHH children was positively correlated with age and EFs, and negatively correlated with aided hearing threshold, while auditory WM could positively predict their spoken language performance.
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Affiliation(s)
- Yuchen Pan
- School of Chinese Language and Culture, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yongtao Xiao
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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İkiz Bozsoy M, Yücel E. Language, cognitive, and speech in noise perception abilities of children with cochlear ımplants: a comparative analysis by implantation period and bilateral versus unilateral cochlear implants. Eur Arch Otorhinolaryngol 2024; 281:3521-3533. [PMID: 38244031 PMCID: PMC11211123 DOI: 10.1007/s00405-024-08462-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE The purpose of this study was to compare the language, cognitive, and speech in noise (SiN) perception abilities of children with cochlear implants (CIs) to those of their peers with NH by grouping them according to their implantation period (12-18 months/19-24 months) and unilateral/bilateral CI use. METHODS The sample comprised 50 children with cochlear implants (CIs) and 20 children with normal hearing (NH), ages 6-9 years. Children's language, cognitive, and speech in noise (SiN) perception skills were assessed. RESULTS Children with CIs between 12 and 18 months and 19 and 24 months performed more poorly than children with NH on language, verbal memory (VM), verbal-short-term memory (V-STM), verbal working memory (V-WM), rapid naming, and speech in noise (SiN) perception abilities measures (p < 0.001). In addition, children with CIs between 19 and 24 months performed worse on rapid naming and V-WM tasks than children with CIs between 12 and 18 months (p < 0.017). Children with unilateral and bilateral CI performed more poorly than children with NH on language, VM, V-STM, V-WM, rapid naming, and SiN perception abilities assessments (p < 0.001). Additionally children with unilateral CI users performed poorly than children with bilateral CI users on SiN perception (p < 0.017). CONCLUSIONS In children with congenital hearing loss (CHL), cochlear implantation between 12 and 18 months or sequential bilateral implantation is not sufficient for these children to perform like their NH peers in language, cognitive, and SiN perception abilities. In addition, intervention approaches should focus not only on increasing language skills, but also on cognitive abilities.
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Affiliation(s)
- Merve İkiz Bozsoy
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey.
| | - Esra Yücel
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey
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Licameli GR, Wang A, Zhou G, Faller D, Kenna M, Poe D, Shearer E, Oster L, Brodsky JR. Vestibular Preservation in Pediatric Cochlear Implantation. Laryngoscope 2024; 134:1913-1918. [PMID: 37584403 DOI: 10.1002/lary.30978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVES Evaluate the rate of preserved vestibular function in pediatric cochlear implant surgery. STUDY DESIGN Retrospective case review. METHODS Pre- and post-operative vestibular tests were compared in children who underwent cochlear implantation at a tertiary level pediatric hospital over a 4-year period. RESULTS Data from 59 implanted ears in 44 children was included. Median age was 2.8 years at initial testing (range 7 months - 21 years) with 1:1 male/female ratio. Implant surgeries were 26 unilateral, 13 bilateral simultaneous, and 5 bilateral sequential. The majority were implanted with slim, non-styletted electrodes (86.4%) via a round window approach (91.5%). Normal pre-operative results were preserved post-operatively on rotary chair testing in 75% (21/28) of patients, cervical vestibular evoked myogenic potential testing in (75%) 30/40 of ears tested, ocular vestibular evoked myogenic potential testing in 85.7% (6/7) of ears tested, video head impulse testing in 100% (9/9) of ears tested, and computerized dynamic posturography in 100% (5/5) of patients tested. Overall, 62.5% of patients had no new deficits on any vestibular test performed post-operatively. CONCLUSIONS Preservation rates of vestibular function following cochlear implant surgery were higher in this cohort than what has been reported in many earlier studies. Contemporary, less traumatic electrodes and insertion techniques may be a significant factor. The risk of causing a new, severe bilateral vestibular loss with long-term functional impacts appears to be low. Further study is warranted on the impacts of different cochlear implant electrode designs and insertion approaches on post-operative vestibular preservation. LEVEL OF EVIDENCE 4, Case Series Laryngoscope, 134:1913-1918, 2024.
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Affiliation(s)
- Greg R Licameli
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Alicia Wang
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Guangwei Zhou
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - David Faller
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Margaret Kenna
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Dennis Poe
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Eliot Shearer
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Linda Oster
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
| | - Jacob R Brodsky
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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Illg A, Adams D, Lesinski-Schiedat A, Lenarz T, Kral A. Variability in Receptive Language Development Following Bilateral Cochlear Implantation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:618-632. [PMID: 38198368 DOI: 10.1044/2023_jslhr-23-00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. DESIGN Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. RESULTS In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. CONCLUSIONS Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.
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Affiliation(s)
- Angelika Illg
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Doris Adams
- Department of Otolaryngology, Medical University Hannover, Germany
| | | | - Thomas Lenarz
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Andrej Kral
- Department of Otolaryngology, Medical University Hannover, Germany
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Sendesen İ, Sendesen E, Yücel E. Evaluation of musical emotion perception and language development in children with cochlear implants. Int J Pediatr Otorhinolaryngol 2023; 175:111753. [PMID: 37839291 DOI: 10.1016/j.ijporl.2023.111753] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES While the primary purpose of cochlear implant (CI) fitting is to improve individuals' receptive and expressive skills, musical emotion perception (MEP) is generally ignored. This study assesses the MEP and language skills (LS) of children using CI. METHODS 26 CI users and 26 matched healthy controls between the ages of 6 and 9 were included in the study. The Test of Language Development (TOLD) was applied to evaluate the LS of the participants, and the Montreal Emotion Identification Test (MEI) was applied to evaluate the MEP. RESULTS MEI test scores and all subtests of TOLD were statistically significantly lower in the CI group. Also, there was a statistically significant and moderate correlation between the listening subtest of TOLD and the MEI test. CONCLUSIONS MEP and language skills are poor in children with CI. Although language skills are primarily targeted in CI performance, improving MEP should also be included in rehabilitation programs. The relationship between music and the TOLD's listening subtest may provide evidence that listening skills can be improved by paying attention to the MEP, which is frequently ignored in rehabilitation programs.
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Affiliation(s)
- İrem Sendesen
- Department of Audiology, Gazi University, Ankara, Turkey; Ankara University, Faculty of Medicine, Otolaryngology Department, Audiology, Speech, Balance Disorders Diagnosis and Rehabilitation Unit, Ankara, Turkey.
| | - Eser Sendesen
- Department of Audiology, Hacettepe University, Ankara, Turkey.
| | - Esra Yücel
- Department of Audiology, Hacettepe University, Ankara, Turkey.
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Pan Y, Zheng H, Xiao Y. Production of Tone 2 in disyllabic words in Mandarin Chinese speaking children aged 3-5 with a cochlear implant and a contralateral hearing aid. CLINICAL LINGUISTICS & PHONETICS 2023; 37:1013-1029. [PMID: 36214108 DOI: 10.1080/02699206.2022.2126332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
To investigate Mandarin Tone 2 production of disyllabic words of prelingually deafened children with a cochlear implant (CI) and a contralateral hearing aid (HA) and to evaluate the relationship between their demographic variables and tone-production ability. Thirty prelingually Mandarin-speaking preschoolers with CI+HA and 30 age-matched normal-hearing (NH) children participated in the study. Fourteen disyllabic words were recorded from each child. A total of 840 tokens (14 × 60) were then used in tone-perception tests in which four speech therapists participated. The production of T2-related disyllabic words of the bimodal group was significantly worse than that of the NH group, as reflected in the overall accuracy (88.57% ± 16.31% vs 99.29% ± 21.79%, p < 0.05), the accuracy of T1+T2 (93.33% vs 100%), the accuracy of T2+T1 (66.67 ± 37.91% vs 98.33 ± 9.13%), and the accuracy of T2+T4 (78.33 ± 33.95% vs 100%). In addition, the bimodal group showed significantly inferior production accuracy of T2+T1 than T2+T2 and T3+T2, p < 0.05. Both bimodal age and implantation age were significantly negatively correlated with the overall production accuracy, p < 0.05. For the error patterns, bimodal participants experienced more errors when T2 was in the first position of the tone combination, and T2 was most likely to be mispronounced as T1 and T3. Bimodal patients aged 3-5 have T2-related disyllabic lexical tone production defects, and their performances are related to tone combination, implantation age, and bimodal age.
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Affiliation(s)
- Yuchen Pan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
| | - Huiping Zheng
- Brain Heal Rehabilitation center, Hangzhou Nans Technology Co., LTD, Zhejiang, Hangzhou, China
| | - Yongtao Xiao
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
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Haukedal CL, Wie OB, Schauber SK, von Koss Torkildsen J. Children With Developmental Language Disorder Have Lower Quality of Life Than Children With Typical Development and Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3988-4008. [PMID: 37708514 DOI: 10.1044/2023_jslhr-22-00742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE The purpose of this study was to examine quality of life (QOL) and its relation to language skills in children with developmental language disorder (DLD). This was examined by comparing QOL to a control group of children with typical development (TD), as well as children with cochlear implants (CIs), who potentially struggle with language for language, although for a different reason than children with DLD. METHOD Two groups of children, a group with TD (n = 29) and a group of children with CIs (n = 29), were matched to the DLD group (n = 29) on chronological age, gender, nonverbal IQ, and parental educational level through a propensity matching procedure. A third group consisting of children with CIs was also matched to the DLD group but additionally matched on language abilities. QOL scores were compared across groups, and the association between language skills and QOL was examined in the DLD group. RESULT The DLD group was reported by parents to have statistically significantly poorer QOL scores than peers with TD or CIs. When controlling for language skills, either statistically or through an additional CI group matched on language abilities, there were no statistically significant differences in QOL scores across groups. In the DLD group, language skills explained 16% of the variation in QOL. CONCLUSION DLD is associated with the children's overall QOL, and the degree of reduced QOL relates to the severity of the language impairment.
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Affiliation(s)
- Christiane Lingås Haukedal
- Faculty of Educational Sciences, Department of Special Needs Education, University of Oslo, Norway
- Department of Vocational Teacher Education, Oslo Metropolitan University, Norway
| | - Ona Bø Wie
- Faculty of Educational Sciences, Department of Special Needs Education, University of Oslo, Norway
| | - Stefan K Schauber
- Centre for Health Sciences Education, University of Oslo, Norway
- Centre for Educational Measurement, University of Oslo, Norway
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Hardman G, Herman R, Kyle FE, Ebbels S, Morgan G. Identifying Developmental Language Disorder in Deaf Children with Cochlear Implants: A Case Study of Three Children. J Clin Med 2023; 12:5755. [PMID: 37685824 PMCID: PMC10488728 DOI: 10.3390/jcm12175755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed.
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Affiliation(s)
- Gemma Hardman
- Department of Language and Communication Science, City, University of London, London EC1V 0HB, UK; (G.H.); (R.H.)
| | - Rosalind Herman
- Department of Language and Communication Science, City, University of London, London EC1V 0HB, UK; (G.H.); (R.H.)
| | - Fiona Elizabeth Kyle
- Deafness, Cognition and Language Research Centre (DCAL), University College London, London WC1E 6BT, UK
| | - Susan Ebbels
- Moor House Research and Training Institute, Moor House School & College, Oxted RH8 9AQ, UK;
- Language and Cognition, Psychology and Language, University College London, London WC1E 6BT, UK
| | - Gary Morgan
- Psychology and Education Department, University Oberta Catalunya, 08035 Barcelona, Spain;
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Koirala N, Deroche MLD, Wolfe J, Neumann S, Bien AG, Doan D, Goldbeck M, Muthuraman M, Gracco VL. Dynamic networks differentiate the language ability of children with cochlear implants. Front Neurosci 2023; 17:1141886. [PMID: 37409105 PMCID: PMC10318154 DOI: 10.3389/fnins.2023.1141886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/29/2023] [Indexed: 07/07/2023] Open
Abstract
Background Cochlear implantation (CI) in prelingually deafened children has been shown to be an effective intervention for developing language and reading skill. However, there is a substantial proportion of the children receiving CI who struggle with language and reading. The current study-one of the first to implement electrical source imaging in CI population was designed to identify the neural underpinnings in two groups of CI children with good and poor language and reading skill. Methods Data using high density electroencephalography (EEG) under a resting state condition was obtained from 75 children, 50 with CIs having good (HL) or poor language skills (LL) and 25 normal hearing (NH) children. We identified coherent sources using dynamic imaging of coherent sources (DICS) and their effective connectivity computing time-frequency causality estimation based on temporal partial directed coherence (TPDC) in the two CI groups compared to a cohort of age and gender matched NH children. Findings Sources with higher coherence amplitude were observed in three frequency bands (alpha, beta and gamma) for the CI groups when compared to normal hearing children. The two groups of CI children with good (HL) and poor (LL) language ability exhibited not only different cortical and subcortical source profiles but also distinct effective connectivity between them. Additionally, a support vector machine (SVM) algorithm using these sources and their connectivity patterns for each CI group across the three frequency bands was able to predict the language and reading scores with high accuracy. Interpretation Increased coherence in the CI groups suggest overall that the oscillatory activity in some brain areas become more strongly coupled compared to the NH group. Moreover, the different sources and their connectivity patterns and their association to language and reading skill in both groups, suggest a compensatory adaptation that either facilitated or impeded language and reading development. The neural differences in the two groups of CI children may reflect potential biomarkers for predicting outcome success in CI children.
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Affiliation(s)
- Nabin Koirala
- Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, United States
| | | | - Jace Wolfe
- Hearts for Hearing Foundation, Oklahoma City, OK, United States
| | - Sara Neumann
- Hearts for Hearing Foundation, Oklahoma City, OK, United States
| | - Alexander G. Bien
- Department of Otolaryngology – Head and Neck Surgery, University of Oklahoma Medical Center, Oklahoma City, OK, United States
| | - Derek Doan
- University of Oklahoma College of Medicine, Oklahoma City, OK, United States
| | - Michael Goldbeck
- University of Oklahoma College of Medicine, Oklahoma City, OK, United States
| | - Muthuraman Muthuraman
- Department of Neurology, Neural Engineering with Signal Analytics and Artificial Intelligence (NESA-AI), Universitätsklinikum Würzburg, Würzburg, Germany
| | - Vincent L. Gracco
- Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, United States
- School of Communication Sciences and Disorders, McGill University, Montreal, QC, Canada
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Tuohimaa K, Loukusa S, Löppönen H, Välimaa T, Kunnari S. Development of Social-Pragmatic Understanding in Children With Congenital Hearing Loss and Typical Hearing Between the Ages of 4 and 6 Years. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-18. [PMID: 37227801 DOI: 10.1044/2023_jslhr-22-00700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE This prospective longitudinal study aimed to explore (a) the development of social-pragmatic understanding of children with bilateral hearing aids (BiHAs), bilateral cochlear implants (BiCIs), and typical hearing (TH) between the ages of 4 and 6 years and (b) group differences between children with BiHAs, BiCIs, and TH. METHOD The Pragma test was used for a comprehensive assessment of social-pragmatic understanding of a total of 86 children: 19 children with BiHAs, 22 children with BiCIs, and 45 children with TH. The Pragma test requires answering socially and contextually demanding questions and explaining the right answers. The explanation tasks are targeted at studying the participant's own awareness of the inferencing process. The children in this study were assessed yearly at the ages of 4, 5, and 6 years. RESULTS The participants with BiHAs, BiCIs, and TH showed significant development in their social-pragmatic understanding between the ages of 4 and 6 years, but most children with hearing loss (HL) still did not meet age expectations at the age of 6 years. Children with BiHAs and BiCIs both showed large-scale inferential difficulties, including utilizing theory of mind, utilizing verbal and visual information, and understanding conversational norms and emotions in context. CONCLUSIONS Children with BiHAs and BiCIs are at risk of delays in social-pragmatic understanding despite early detection of HL, early amplification, and cochlear implantation. Therefore, the social-pragmatic abilities of children with HL should be assessed regularly, and the children with HL should have early access to social-pragmatic interventions where utilizing contextual information is practiced comprehensively.
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Affiliation(s)
- Krista Tuohimaa
- Research Unit of Logopedics, University of Oulu, Finland
- Child Language Research Center, University of Oulu, Finland
| | - Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Finland
- Child Language Research Center, University of Oulu, Finland
| | - Heikki Löppönen
- Department of Otorhinolaryngology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio
- Department of Otorhinolaryngology-Head and Neck Surgery, Kuopio University Hospital, Finland
| | - Taina Välimaa
- Research Unit of Logopedics, University of Oulu, Finland
- Child Language Research Center, University of Oulu, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, University of Oulu, Finland
- Child Language Research Center, University of Oulu, Finland
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Fei P, Shehata-Dieler W, Huestegge L, Hagen R, Kühn H. Longitudinal Development of Verbal and Nonverbal Intelligence After Cochlear Implantation According to Wechsler Tests in German-speaking Children: A Preliminary Study. Ear Hear 2023; 44:264-275. [PMID: 36163636 DOI: 10.1097/aud.0000000000001278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Intelligence as a construct of cognitive abilities is the basis of knowledge and skill acquisition and the main predictor of academic achievement. As a broad construct, it is usually divided into subdomains, such as nonverbal and verbal intelligence. Verbal intelligence is one domain of intelligence but is not synonymous with specific linguistic abilities like grammar proficiency. We aim to address the general expectation that early cochlear implantation enables children who are hard of hearing to develop comprehensively, including with respect to verbal intelligence. The primary purpose of this study is to trace the longitudinal development of verbal and nonverbal intelligence in children with cochlear implants (CIs). DESIGN Sixteen children with congenital hearing loss who received unilateral or bilateral implants and completed at least two intelligence assessments around the age of school entrance were included in the study. The first assessment was performed around 3 years after CI fitting (chronological age range: 3.93 to 7.03 years). The second assessment was performed approximately 2 years after the first assessment. To analyze verbal and nonverbal IQ in conjunction and across children at different ages, we used corresponding standardized and normalized tests from the same test family (Wechsler Preschool and Primary Scale of Intelligence and/or Wechsler Intelligence Scale for Children). RESULTS Regarding longitudinal development, both verbal and nonverbal IQ increased, but verbal IQ increased more substantially over time. At the time of the second measurement, verbal and nonverbal IQ were on a comparable level. Nevertheless, we also observed strong inter-individual differences. The duration between both assessments was significantly associated with verbal IQ at the second measurement time point and thus with verbal IQ gain over time. Education mode (regular vs. special kindergarten/school) was significantly correlated with nonverbal IQ at the second assessment time point. CONCLUSIONS The results, despite the small sample size, clearly suggest that children with CIs can achieve intellectual abilities comparable to those of their normal-hearing peers by around the third year after initial CI fitting, and they continue to improve over the following 2 years. We recommend further research focusing on verbal IQ assessed around the age of school entrance to be used as a predictor for further development and for the establishment of an individual educational program.
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Affiliation(s)
- Peipei Fei
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Lynn Huestegge
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Heike Kühn
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
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Klein KE, Walker EA, McMurray B. Delayed Lexical Access and Cascading Effects on Spreading Semantic Activation During Spoken Word Recognition in Children With Hearing Aids and Cochlear Implants: Evidence From Eye-Tracking. Ear Hear 2023; 44:338-357. [PMID: 36253909 PMCID: PMC9957808 DOI: 10.1097/aud.0000000000001286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE The objective of this study was to characterize the dynamics of real-time lexical access, including lexical competition among phonologically similar words, and spreading semantic activation in school-age children with hearing aids (HAs) and children with cochlear implants (CIs). We hypothesized that developing spoken language via degraded auditory input would lead children with HAs or CIs to adapt their approach to spoken word recognition, especially by slowing down lexical access. DESIGN Participants were children ages 9- to 12-years old with normal hearing (NH), HAs, or CIs. Participants completed a Visual World Paradigm task in which they heard a spoken word and selected the matching picture from four options. Competitor items were either phonologically similar, semantically similar, or unrelated to the target word. As the target word unfolded, children's fixations to the target word, cohort competitor, rhyme competitor, semantically related item, and unrelated item were recorded as indices of ongoing lexical access and spreading semantic activation. RESULTS Children with HAs and children with CIs showed slower fixations to the target, reduced fixations to the cohort competitor, and increased fixations to the rhyme competitor, relative to children with NH. This wait-and-see profile was more pronounced in the children with CIs than the children with HAs. Children with HAs and children with CIs also showed delayed fixations to the semantically related item, although this delay was attributable to their delay in activating words in general, not to a distinct semantic source. CONCLUSIONS Children with HAs and children with CIs showed qualitatively similar patterns of real-time spoken word recognition. Findings suggest that developing spoken language via degraded auditory input causes long-term cognitive adaptations to how listeners recognize spoken words, regardless of the type of hearing device used. Delayed lexical access directly led to delays in spreading semantic activation in children with HAs and CIs. This delay in semantic processing may impact these children's ability to understand connected speech in everyday life.
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Affiliation(s)
- Kelsey E Klein
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Elizabeth A Walker
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
| | - Bob McMurray
- Department of Psychological and Brain Sciences, Department of Communication Sciences and Disorders, and Department of Otolaryngology, University of Iowa, Iowa City, Iowa, USA
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Alkhamra R, Alkhamra H. Assessing school readiness in children with cochlear implants using an Arabic language-based test. SPEECH, LANGUAGE AND HEARING 2023. [DOI: 10.1080/2050571x.2023.2178760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Rana Alkhamra
- Department of Hearing and Speech Sciences, University of Jordan, Amman, Jordan
| | - Hatem Alkhamra
- Department of Special Education, University of Jordan, Amman, Jordan
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Walker EA. The Importance of High-Frequency Bandwidth on Speech and Language Development in Children: A Review of Patricia Stelmachowicz's Contributions to Pediatric Audiology. Semin Hear 2023; 44:S3-S16. [PMID: 36970651 PMCID: PMC10033203 DOI: 10.1055/s-0043-1764138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
We review the literature related to Patricia Stelmachowicz's research in pediatric audiology, specifically focusing on the influence of audibility in language development and acquisition of linguistic rules. Pat Stelmachowicz spent her career increasing our awareness and understanding of children with mild to severe hearing loss who use hearing aids. Using a variety of novel experiments and stimuli, Pat and her colleagues produced a robust body of evidence to support the hypothesis that development moderates the role of frequency bandwidth on speech perception, particularly for fricative sounds. The prolific research that came out of Pat's lab had several important implications for clinical practice. First, her work highlighted that children require access to more high-frequency speech information than adults in the detection and identification of fricatives such as /s/ and /z/. These high-frequency speech sounds are important for morphological and phonological development. Consequently, the limited bandwidth of conventional hearing aids may delay the formation of linguistic rules in these two domains for children with hearing loss. Second, it emphasized the importance of not merely applying adult findings to the clinical decision-making process in pediatric amplification. Clinicians should use evidence-based practices to verify and provide maximum audibility for children who use hearing aids to acquire spoken language.
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Affiliation(s)
- Elizabeth A. Walker
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa
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15
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Boonen N, Kloots H, Nurzia P, Gillis S. Spontaneous speech intelligibility: early cochlear implanted children versus their normally hearing peers at seven years of age. JOURNAL OF CHILD LANGUAGE 2023; 50:78-103. [PMID: 36503545 DOI: 10.1017/s0305000921000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Speaking intelligibly is an important achievement in children's language development. How far do congenitally severe-to-profound hearing-impaired children who received a cochlear implant (CI) in the first two years of their life advance on the path to intelligibility in comparison to children with typical hearing (NH)? Spontaneous speech samples of children with CI and children with NH were orthographically transcribed by naïve transcribers. The entropy of the transcriptions was computed to analyze their degree of uniformity. The same samples were also rated on a continuous rating scale by another group of adult listeners. The transcriptions of the NH children's speech were more uniform, i.e., had significantly lower entropy, than those of the CI children, suggesting that the latter group displayed lower intelligibility. This was confirmed by the ratings on the continuous scale. Despite the relatively restricted age ranges, older children reached better intelligibility scores in both groups.
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Affiliation(s)
- Nathalie Boonen
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Hanne Kloots
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Pietro Nurzia
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Steven Gillis
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
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16
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad Jr F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology - hearing loss in children - Part II - Treatment. Braz J Otorhinolaryngol 2022; 89:190-206. [PMID: 36528468 PMCID: PMC9874354 DOI: 10.1016/j.bjorl.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0-18 years. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. CONCLUSIONS In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil,Corresponding author.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad Jr
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil,Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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Culbertson SR, Dillon MT, Richter ME, Brown KD, Anderson MR, Hancock SL, Park LR. Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children With Congenital Deafness. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3539-3547. [PMID: 36001854 PMCID: PMC9913281 DOI: 10.1044/2022_jslhr-22-00039] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/27/2022] [Accepted: 06/04/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spoken language outcomes. As auditory skills are a precursor to the development of spoken language, this study was developed to investigate the influence of age at CI activation on auditory skill acquisition in young children. A secondary aim was to describe the auditory skills of children implanted prior to 9 months of age as compared to children with older ages of activation. METHOD Functional Listening Index (FLI) scores obtained during routine clinical visits were reviewed for 78 pediatric CI recipients with congenital bilateral profound hearing loss who were activated before 2 years of age. A linear mixed-effects model assessed the effect of age at CI activation on cumulative FLI scores over time. RESULTS There was a significant interaction between age at activation and chronological age at the time of evaluation, indicating that children with earlier access to sound achieved a greater number of auditory skills than those with later CI activations when measured at the same chronological age. Children activated before the age of 9 months approximated scores expected of children with typical hearing, whereas children activated between 9 and 24 months of age did not. CONCLUSIONS Younger age at CI activation is associated with increased auditory skills over time. Children who undergo cochlear implantation and CI activation before 9 months achieve more auditory skills by 4 years of age than children who are activated at later ages. These data suggest that reducing the approved age at cochlear implantation for children with congenital bilateral profound SNHL may support optimal auditory skill acquisition.
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Affiliation(s)
- Shannon R. Culbertson
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret E. Richter
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Melissa R. Anderson
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Sandra L. Hancock
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
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18
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Glaubitz C, Geiss KT, Hoppe U. [Word production in children with cochlear implant based on chronological age and hearing age]. Laryngorhinootologie 2022; 101:886-895. [PMID: 36055256 DOI: 10.1055/a-1925-7757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND For congenitally deaf children, an early bilateral provision with cochlear implant (CI) is a favourable condition for language acquisition. The objective of the present study was to determine the word production in CI children. The focus was on a comparison of chronological age and hearing age performance and on the evaluation of potential effects of multilingualism, additional disabilities and age at provision. METHODS The data of 62 children with bilateral CI (age at provision in months M=12,1; SD=6,2) were retrospectively analysed. Vocabulary was assessed by the test Aktiver Wortschatztest für 3- bis 5-jährige Kinder - Revision and compared for chronological age and hearing age. Group comparisons and correlation analysis was conducted regarding multilingualism, additional disabilities and age at provision. RESULTS The cohort performed significantly better when referenced to hearing age: level were within or above the norm in more than 50%; referenced to chronological age in around 37%. The descriptive performance differences for multilingualism and additional disabilities were only significant for children with both characteristics. Performance of monolingual children without additional disabilities was not significantly associated with age at provision. CONCLUSION CI children may achieve an adequate expressive vocabulary at the age of 3 to 5 years. Multilingualism and additional disabilities seem to be particular challenges for CI children and need a more precise definition in further studies. The use of both chronological and hearing age as reference marks allows a differentiated assessment of the language status. This may lead to benefits in therapeutic interventions and parent councelling.
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Affiliation(s)
- Cynthia Glaubitz
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
| | - Katrin T Geiss
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
| | - Ulrich Hoppe
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
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Tuohimaa K, Loukusa S, Löppönen H, Välimaa T, Kunnari S. Communication abilities in children with hearing loss - views of parents and daycare professionals. JOURNAL OF COMMUNICATION DISORDERS 2022; 99:106256. [PMID: 36029613 DOI: 10.1016/j.jcomdis.2022.106256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Today, children with hearing loss (HL) are diagnosed and fitted with hearing devices at an early age. However, HL may still influence their communicative development. Thus, we need up-to-date research on how children perform in their everyday environments, such as at home or daycare. This study provides an overview of the communication abilities of early-diagnosed children with HL reported by parents and daycare professionals. The first aim of the study is to compare the results of children with bilateral hearing aids (BiHAs) or bilateral cochlear implants (BiCIs) with those of children with normal hearing (NH) and with each other. The second aim of the study is to compare the views of the two respondents, parents and the daycare professionals. In addition, the effects of gender and nonverbal intelligence quotient (IQ) on the responses are explored. METHODS The participants, aged 4;0-6;9, were 25 children with BiHAs, 29 children with BiCIs, and 64 children with NH. The Finnish version of the Children's Communication Checklist-2 (CCC-2) was used to assess the communication skills of the participants. RESULTS Group and nonverbal IQ had a significant effect on the General Communication Composite (GCC) score. Both groups of children with HL had poorer GCC scores than the children with NH, apart from the respondent. The BiHA-group had significantly lower scores than the NH-group on Speech, Syntax, Semantics, and Coherence subscales. The BiCI-group had significantly lower scores than the NH-group across all subscales of the CCC-2. The parents rated the participants significantly higher than the daycare professionals in Speech and Social Relations. In contrast, the daycare professionals rated the participants higher than the parents in Coherence, Inappropriate Initiation, Stereotyped Language, and Use of Context. Furthermore, gender influenced Coherence, Nonverbal Communication, Social Relations, and Interests, for which the girls performed better than the boys. The nonverbal IQ had an effect on Syntax, Semantics, and Use of Context, for which higher nonverbal IQ was associated with better performance. CONCLUSIONS On average the children with HL had poorer communication skills than the children with NH. Pragmatic difficulties were more common in the BiCI-group than in the BiHA-group. The respondents were not completely unanimous, which may be because of the different demands of different environments.
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Affiliation(s)
- Krista Tuohimaa
- Research Unit of Logopedics, University of Oulu, Finland; Child Language Research Center, University of Oulu, Finland.
| | - Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Finland; Child Language Research Center, University of Oulu, Finland
| | - Heikki Löppönen
- Institute of Clinical Medicine, Department of Otorhinolaryngology, University of Eastern Finland, Finland; Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital, Finland
| | - Taina Välimaa
- Research Unit of Logopedics, University of Oulu, Finland; Child Language Research Center, University of Oulu, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, University of Oulu, Finland; Child Language Research Center, University of Oulu, Finland
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Andreeva IG, Ogorodnikova EA. Auditory Adaptation to Speech Signal Characteristics. J EVOL BIOCHEM PHYS+ 2022. [DOI: 10.1134/s0022093022050027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Arjmandi MK, Herrmann BS, Caswell-Midwinter B, Doney EM, Arenberg JG. A Modified Pediatric Ranked Order Speech Perception Score to Assess Speech Recognition Development in Children With Cochlear Implants. Am J Audiol 2022; 31:613-632. [PMID: 35767328 PMCID: PMC9886162 DOI: 10.1044/2022_aja-21-00212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Characterizing and comparing speech recognition development in children with cochlear implants (CIs) is challenging because of variations in test type. This retrospective cohort study modified the Pediatric Ranked Order Speech Perception (PROSPER) scoring system to (a) longitudinally analyze the speech perception of children with CIs and (b) examine the role of age at CI activation, listening mode (i.e., unilateral or bilateral implantation), and interimplant interval. METHOD Postimplantation speech recognition scores from 31 children with prelingual, severe-to-profound hearing loss who received CIs were analyzed (12 with unilateral CI [UniCI], 13 with sequential bilateral CIs [SEQ BiCIs], and six with simultaneous BiCIs). Data were extracted from the Massachusetts Eye and Ear Audiology database. A version of the PROSPER score was modified to integrate the varying test types by mapping raw scores from different tests into a single score. The PROSPER scores were used to construct speech recognition growth curves of the implanted ears, which were characterized by the slope of the growth phase, the time from activation to the plateau onset, and the score at the plateau. RESULTS While speech recognition improved considerably for children following implantation, the growth rates and scores at the plateau were highly variable. In first implanted ears, later implantation was associated with poorer scores at the plateau (β = -0.15, p = .01), but not growth rate. The first implanted ears of children with BiCIs had better scores at the plateau than those with UniCI (β = 0.59, p = .02). Shorter interimplant intervals in children with SEQ BiCIs promoted faster speech recognition growth of the first implanted ears. CONCLUSION The modified PROSPER score could be used clinically to track speech recognition development in children with CIs, to assess influencing factors, and to assist in developing and evaluating patient-specific intervention strategies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20113538.
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Affiliation(s)
- Meisam K. Arjmandi
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston,Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston,Audiology Division, Massachusetts Eye and Ear, Boston
| | - Barbara S. Herrmann
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston,Audiology Division, Massachusetts Eye and Ear, Boston
| | - Benjamin Caswell-Midwinter
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston,Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston,Audiology Division, Massachusetts Eye and Ear, Boston
| | | | - Julie G. Arenberg
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston,Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston,Audiology Division, Massachusetts Eye and Ear, Boston
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Urík M, Šikolová S, Hošnová D, Kruntorád V, Bartoš M, Jabandžiev P. Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children. J Pers Med 2022; 12:jpm12081326. [PMID: 36013275 PMCID: PMC9410025 DOI: 10.3390/jpm12081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Objectives: For full benefit in children implanted with a cochlear implant (CI), wearing the device all waking hours is necessary. This study focuses on the relationship between daily use and audiological outcomes, with the hypothesis that frequent daily device use coincides with high device satisfaction resulting in better functional gain (FG). Confounding factors such as implantation age, device experience and type of device were considered. (2) Results: Thirty-eight CI children (65 ears) were investigated. In total, 76.92% of the children were using their device for >12 h per day (h/d), 18.46% for 9−12 h/d, the remaining for 6−9 h/d and one subject reported 3 h/d. The revision rate up to the 90-month follow-up (F/U) was 4.6%. The mean FG was 59.00 ± 7.67 dB. The Audio Processor Satisfaction Questionnaire (APSQ) separated for single unit (SU) versus behind the ear (BTE) devices showed significantly better results for the latter in terms of wearing comfort (WC) (p = 0.00062). A correlation between device use and FG was found with a device experience of <2 years (n = 29; r2 = 0.398), whereas no correlation was seen with ≥2 years of device experience (n = 36; r2 = 0.0038). (3) Conclusion: This study found significant relationships between daily device use and FG, wearing comfort and long-term safety (90 months).
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Affiliation(s)
- Milan Urík
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-440
| | - Soňa Šikolová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Dagmar Hošnová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Vít Kruntorád
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Michal Bartoš
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Petr Jabandžiev
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Department of Pediatrics, University Hospital Brno, 61300 Brno, Czech Republic
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Sociodemographic disparities in pediatric cochlear implantation outcomes: A systematic review. Am J Otolaryngol 2022; 43:103608. [PMID: 35988363 DOI: 10.1016/j.amjoto.2022.103608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine the impact of sociodemographic factors on post-operative performance outcomes among PCI recipients across the world. METHODS A qualitative systematic review of PubMed, Scopus, Web of Science, and Embase was undertaken for studies analyzing the association of sociodemographic factors with measures of PCI outcomes published before July 18, 2021. Study quality assessment tools from the National Institutes of Health (NIH) were used to assess for risk of bias. RESULTS Out of 887 unique abstracts initially retrieved, 45 papers were included in the final qualitative systematic review. Sociodemographic disparities in PCI outcomes from 4702 PCI recipients were studied in 19 countries, with 14 studies conducted in the United States of America, published within the years of 1999 to 2021. Parental education and socioeconomic status (e.g. income) were the most investigated disparities in PCI outcomes with 24 and 17 identified studies, respectively. CONCLUSION Socioeconomic status was a consistently reported determinant of PCI outcomes in the USA and elsewhere, and parental education, the most reported disparity, consistently impacted outcomes in countries outside the USA. This study is limited by our inability to perform a meta-analysis given the lack of standardization across measures of sociodemographic variables and assessment measures for PCI outcomes. Future studies should address the literature gap on racial and ethnic disparities among PCI outcomes and use standardized measures for sociodemographic variables and PCI outcomes to facilitate meta-analyses on the topic. Targeting the mechanisms of these disparities may mitigate the impact of the sociodemographic factors on PCI outcomes.
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Cochlear Implantation in Young Mandarin-Speaking Children: One Year After First Fitting. Otol Neurotol 2022; 43:e645-e650. [PMID: 35761456 DOI: 10.1097/mao.0000000000003555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Bilateral cochlear implantation has been shown to be beneficial in terms of sound localization and speech recognition in children with congenital deafness. However, little is known about the benefits of bilateral cochlear implantationin children who communicate in a tonal language such as Mandarin. This study aims to investigate the auditory perception and speech intelligibility of Mandarin-speaking children 1 year after first fitting. MATERIALS AND METHODS Twenty-nine children aged between 11.5 and 17.9 months with severe-to-profound bilateral sensorineural hearing loss were recruited; 10 were unilaterally implanted and 19 were bilaterally implanted. A test battery was used to monitor improvements during the first year of cochlear implant use. RESULTS Bilaterally implanted children scored better in the spatial domain of the Speech, Spatial and Qualities of hearing scale for Parents (SSQ-P) in comparison to unilaterally implanted children. Significant improvements were observed in auditory performance and speech intelligibility at 6 and 12 months after first fitting for both groups of children. DISCUSSION Young children that speak a tonal language, such as Mandarin, can obtain significant improvements in hearing and speech abilities within the first year of cochlear implant use. Furthermore, bilateral implantation provides users with better spatial hearing in comparison to unilateral implantation.
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Li G, Zhao F, Tao Y, Zhang L, Zheng Y. Trajectories of receptive and expressive vocabulary in Mandarin speaking children under 4 years of age fitted with cochlear implants: a 12-month longitudinal study. Int J Audiol 2022:1-9. [PMID: 35608224 DOI: 10.1080/14992027.2022.2071769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore trajectories of receptive and expressive vocabulary in Mandarin-speaking children under the age of 4 years, fitted with cochlear implants (CIs). DESIGN Vocabulary trajectories were measured at baseline, 3, 6, and 12 months after implantation using the Chinese version of the MacArthur-Bates Communicative Development Inventory. STUDY SAMPLE There were 216 children with CIs in West China Hospital who took part and were divided into three groups based on age at first CI. RESULTS Receptive and expressive vocabulary scores of the younger implantation group were significantly different from the older groups at baseline. After 12 months of implant use, there were no significant differences between all groups. Furthermore receptive vocabulary trajectories for all children with CIs were not significantly different from those of children with normal hearing. However, expressive vocabulary trajectories were poorer when compared to children with normal hearing. Significant differences were seen between receptive and expressive vocabulary in all age groups. CONCLUSIONS This study suggests no differences in vocabulary trajectories in Mandarin-speaking children whether they received their first CI at 1, 2, or 3 years of age. It is important that clinicians convey realistic expectations about potential differences in receptive vs. expressive trajectories for Mandarin-speaking children fitted with CIs.
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Affiliation(s)
- Gang Li
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Yong Tao
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Lin Zhang
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Yun Zheng
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
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Busch T, Brinchmann EI, Braeken J, Wie OB. Receptive Vocabulary of Children With Bilateral Cochlear Implants From 3 to 16 Years of Age. Ear Hear 2022; 43:1866-1880. [PMID: 35426854 PMCID: PMC9592181 DOI: 10.1097/aud.0000000000001220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The vocabulary of children with cochlear implants is often smaller than that of their peers with typical hearing, but there is uncertainty regarding the extent of the differences and potential risks and protective factors. Some studies indicate that their receptive vocabulary develops well at first, but that they fail to keep up with their typical hearing peers, causing many CI users to enter school with a receptive vocabulary that is not age-appropriate. To better understand the receptive vocabulary abilities of children with cochlear implants this study explored age-related differences to matched children with typical hearing and associations between vocabulary skills and child-level characteristics. DESIGN A retrospective cross-sectional study with matched controls was conducted at the Norwegian national cochlear implant center at Oslo University Hospital. Eighty-eight children (mean age 8.7 years; range 3.2 to 15.9; 43 girls, 45 boys) who had received bilateral cochlear implants before 3 years of age were compared with two groups of children with typical hearing. One group was matched for maternal education, sex, and chronological age, the other group was matched for maternal education, sex, and hearing age. Receptive vocabulary performance was measured with the British Picture Vocabulary Scale. RESULTS Cochlear implant users' receptive vocabulary was poorer than that of age-matched children with typical hearing ( M = 84.6 standard points, SD = 21.1; children with typical hearing: M = 102.1 standard points, SD = 15.8; mean difference -17.5 standard points, 95% CI [-23.0 to -12.0], p < 0.001; Hedges's g = -0.94, 95% CI [-1.24 to -0.62]), and children with cochlear implants were significantly more likely to perform below the normative range (risk ratio = 2.2, 95% CI [1.42 to 3.83]). However, there was a significant nonlinear U-shaped effect of age on the scores of cochlear implant users, with the difference to the matched typical hearing children being largest (23.9 standard points, on average) around 8.7 years of age and smaller toward the beginning and end of the age range. There was no significant difference compared with children with typical hearing when differences in auditory experience were accounted for. Variability was not significantly different between the groups. Further analysis with a random forest revealed that, in addition to chronological age and hearing age, simultaneous versus sequential implantation, communication mode at school, and social integration were predictors of cochlear implant users' receptive vocabulary. CONCLUSIONS On average, the receptive vocabulary of children with cochlear implants was smaller than that of their typical hearing peers. The magnitude of the difference was changing with age and was the largest for children in early primary school. The nonlinear effect of age might explain some of the ambiguity in previous research findings and could indicate that better intervention is required around school entry. The results emphasize that continuous monitoring and support are crucial to avoid far-reaching negative effects on the children's development and well-being.
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Affiliation(s)
- Tobias Busch
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | | | - Johan Braeken
- Centre for Educational Measurement, University of Oslo, Oslo, Norway
| | - Ona Bø Wie
- Department of Special Needs Education, University of Oslo, Oslo, Norway,Department of Otolaryngology, Oslo University Hospital, Oslo, Norway
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Xu L, Luo J, Wang M, Xie D, Chao X, Li J, Liu X, He S, Spencer L, Guo LY. Vocabulary Growth in Mandarin-Speaking Children With Bilateral Cochlear Implants, Bimodal Stimulation, or Unilateral Cochlear Implants During the First Year After Activation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1630-1645. [PMID: 35302899 DOI: 10.1044/2021_jslhr-21-00454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to evaluate vocabulary development in Mandarin-speaking children with bilateral cochlear implants (CIs), bimodal stimulation (CI plus hearing aids [HAs]), or unilateral CIs during the first year after CI activation. METHOD Participants included 23 children with simultaneous bilateral CIs, 23 children with bimodal stimulation, and 15 children with unilateral CIs. They all received CIs before 30 months of age. Parents were asked to endorse words that their child could understand only or understand and say using the Early Vocabulary Inventory for Mandarin Chinese at the day of CI activation and 1, 3, 6, 9, and 12 months after CI activation. Receptive and expressive vocabulary sizes were computed. RESULTS Growth curve analysis revealed that children with simultaneous bilateral CIs demonstrated faster growth of receptive vocabulary than those with bimodal stimulation, followed by those with unilateral CIs. Moreover, children with simultaneous bilateral CIs reached the 100-word mark for receptive vocabulary earlier than children with bimodal stimulation, followed by those with unilateral CIs. There were no significant differences among the three groups in expressive vocabulary. CONCLUSIONS Bilateral CIs have an advantage over bimodal stimulation in early receptive vocabulary development in Mandarin, a tone language. HA usage is still recommended for those who receive one CI.
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Affiliation(s)
- Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Min Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Dianzhao Xie
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xianqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus
- Department of Audiology, Nationwide Children's Hospital, Columbus, OH
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
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Wischmann S, Josvassen JL, Schiøth C, Percy-Smith L. History re-written for children with hearing impairment. Int J Pediatr Otorhinolaryngol 2022; 152:110991. [PMID: 34856491 DOI: 10.1016/j.ijporl.2021.110991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 11/19/2022]
Abstract
UNLABELLED A new generation of children with hearing impairment (HI) has emerged due to introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances in the field of paediatric audiology. AIM The primary aim of the study was to investigate long-term development of language fundamentals of children with HI at school level and analyse associations to several background variables. METHOD AND MATERIAL The project design is prospective, longitudinal and comparative and was conducted over a three-year period with annual testing of core language, expressive language, working memory and pragmatics. Language scores were compared to type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being and start age of use of hearing technology. A total of 56 children participated (Children with HI N = 47; Children with normal hearing (NH) N = 9). Intervention included early start and full time use of hearing technology and 3 years of Auditory Verbal (AV) guidance at school level. RESULTS Children with HI scored within the norm on all language fundamentals and showed high scores on parental assessments of level of social well-being. No significant association was found between any of the language fundamentals and social well-being. Children with HI and a diagnosed additional disability showed positive progression in terms of language development over the three years. CONCLUSION The new generation of children with HI showed potentials of developing language fundamentals within normal range and thrived in terms of social well-being. Opportunities exist for children to be fully included in their respective local hearing community, if qualitative technical and educational intervention is provided.
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Affiliation(s)
- Signe Wischmann
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 8, DK-2100, Kobehnhavn O, Denmark.
| | - Jane Lignel Josvassen
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 8, DK-2100, Kobehnhavn O, Denmark; Decibel, Lyngbyvej 11, 1. sal L. 104, DK-2100, Kobenhavn O, Denmark
| | | | - Lone Percy-Smith
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 8, DK-2100, Kobehnhavn O, Denmark
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Yin X, Gu H, Kong W, Li G, Zheng Y. Early prelingual auditory and language development in children with simultaneous bilateral and unilateral cochlear implants. Front Pediatr 2022; 10:999689. [PMID: 36405825 PMCID: PMC9669896 DOI: 10.3389/fped.2022.999689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This current study aimed to explore early prelingual auditory development (EPLAD) and early language development in Mandarin-speaking children who received simultaneous bilateral cochlear implants (BICI) during the first year of cochlear implantation and compare the performance of the children who received BICI with those received unilateral cochlear implant (UCI). METHODS 39 Mandarin-speaking children who received BICIs simultaneously and 36 children with UCIs were enrolled in this study. To access the EPLAD, the Infant-Toddler Meaningful Auditory Integration Scale (IT/MAIS) was conducted, and a subtest of the simplified short-form version of the Mandarin Communicative Development Inventory (SSF-MCDI) was used to evaluate the development of expressive and receptive vocabulary for the children at indicated time points after surgery. RESULTS In both the simultaneous BICI and UCI groups, we observed significantly increased scores of the SSF-MCDI and IT/MAIS 1 year after the surgery. There are indications of early advantages in children with BICI in IT/MAIS scores (at 1, 3, and 6 months after activation). For early development of language, a great difference between the expressive vocabulary scores and the receptive vocabulary scores was observed in both groups. We found there were not significant differences between the two groups on expressive or receptive vocabulary scores, the use of more differentiated measures might be required in future research. We further found that the development of the receptive or expressive vocabulary is dramatically correlated with the age at implantation and the total scores of IT/MAIS for children with simultaneous BICIs. CONCLUSION These results may supplement the skills development of early language and auditory in Mandarin-native children with simultaneous CIs. It is obvious that children with normal hearing have mastery of receptive vocabulary before that of expressive vocabulary, which is the same as children with unilateral and bilateral CIs in this research. IT/MAIS total scores and age at CI were important factors for early language performance in children with simultaneous BICIs.
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Affiliation(s)
- Xiaoling Yin
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Hailing Gu
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Weili Kong
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Gang Li
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yun Zheng
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
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Park LR, Gagnon EB, Brown KD. The Limitations of FDA Criteria: Inconsistencies with Clinical Practice, Findings, and Adult Criteria as a Barrier to Pediatric Implantation. Semin Hear 2021; 42:373-380. [PMID: 34912165 PMCID: PMC8660172 DOI: 10.1055/s-0041-1739370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Children require greater access to sound than adults as they are learning to communicate using hearing and spoken language. Yet when it comes to cochlear implant candidacy, currently approved Food and Drug Administration (FDA) criteria for adults are much less restrictive than those for children, allowing for greater levels of residual hearing and aided speech recognition in adults. Cochlear implant guidelines for children have changed very little in the 30 years since cochlear implants have been approved for pediatrics, and this lack of change has proven to be a barrier to implantation. Using evidence-based practice, centers have been providing off-label implantation for children who fall outside of current FDA criteria, including children with more residual hearing, children with single-side deafness younger than 5 years, and infants with bilateral profound loss younger than 9 months. The purpose of this article is to outline how these restrictions impede access to implants for children and describe the evidence supporting cochlear implantation in children who fall outside of current criteria.
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Affiliation(s)
- Lisa R Park
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
| | - Erika B Gagnon
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
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Cejas I, Mitchell CM, Barker DH, Sarangoulis C, Eisenberg LS, Quittner AL. Parenting Stress, Self-Efficacy, and Involvement: Effects on Spoken Language Ability Three Years After Cochlear Implantation. Otol Neurotol 2021; 42:S11-S18. [PMID: 34766939 PMCID: PMC8597911 DOI: 10.1097/mao.0000000000003374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study evaluated associations among parenting stress, self-efficacy, and involvement in relation to spoken language outcomes in young children 3 years following cochlear implantation. STUDY DESIGN Cross-sectional. SETTING Six university tertiary medical centers. PATIENTS One hundred sixty-four young children with bilateral, severe-to-profound sensorineural hearing loss who had 3 years of experience with a CI; children with substantial cognitive impairments were excluded from the study. MAIN OUTCOME MEASURESS Family Stress Scale (FSS), Scale of Parental Involvement and Self-Efficacy (SPISE), Oral and Written Language Scales (OWLS). RESULTS Correlations were of moderate strength between FSS scores and SPISE scores (Parental Self-Efficacy, r = -0.45, p < 0.01, Parental Involvement r = -0.32, p < 0.01). As hypothesized, parents reporting higher levels of stress reported lower perceptions of self-efficacy and involvement. In addition, results showed that family stress had a direct, negative effect on spoken language (-4.43 [95% confidence interval: -6.97; -1.89]). After controlling for maternal education and activation age, parental self-efficacy mediated the negative effect between family stress and spoken language (indirect effect = -1.91 [3.45; -0.69]; proportion mediated = 0.43). No mediating effects were found for parental involvement. CONCLUSIONS These findings highlight the need for parenting interventions that focus on reducing stressors and increasing parents' perceptions of self-efficacy in families of children using cochlear implants. Integration of mental health screening and tailored parenting interventions in CI clinics may increase parental self-efficacy and involvement, with measurable benefits in the child's use of spoken language.
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Affiliation(s)
- Ivette Cejas
- Department of Otolaryngology, University of Miami Ear Institute, Miami, FL
| | - Christine M. Mitchell
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - David H. Barker
- Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI
- Department of Psychiatry, Rhode Island Hospital, Providence, RI
| | | | - Laurie S. Eisenberg
- Caruso Department of Otolaryngology, Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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The impact of early auditory experience for the acquisition of morphosyntactic abilities and working memory. Cortex 2021; 145:273-284. [PMID: 34775264 DOI: 10.1016/j.cortex.2021.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/15/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022]
Abstract
Difficulty in acquiring object clitics (OCs), and the omission of OCs more specifically, is used as a marker of developmental language disorder (DLD) in children learning French. Research also suggests that OCs are a complex morphosyntactic property of French and, as such, they could be particularly taxing for working memory (WM) resources. In light of previous research, it seems more likely that difficulties with OCs could be a marker for atypical early language acquisition. Children receiving a cochlear implant (CI) represent a case of delayed language exposure linked to a lack of early auditory exposure. Few studies have investigated the production of clitics in children with CIs. Studies suggest that children with CIs make significantly more clitic omissions on tasks of clitic production than typically-developing (TD) children. To our knowledge, no study has looked at clitic comprehension in children with CIs learning French or at the relationship between WM and performance on tasks of OCs in this population. The present study aimed at examining the production and comprehension of OCs, as well as the relationship between clitic omission and WM, in both typically-developing monolinguals children and CI recipients learning French. Children with CIs performed significantly lower than the control group on both comprehension and production tasks. Clitic omission was significantly related to WM, but only in the CI group suggesting a differential relationship between early auditory experience, WM, and language acquisition.
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Pluta A, Krysztofiak M, Zgoda M, Wysocka J, Golec K, Wójcik J, Włodarczyk E, Haman M. False Belief Understanding in Deaf Children With Cochlear Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:511-521. [PMID: 34179946 PMCID: PMC8448438 DOI: 10.1093/deafed/enab015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 05/31/2023]
Abstract
Theory of mind (ToM) is crucial for social interactions. Previous research has indicated that deaf and hard-of-hearing children born into hearing families (DoH) are at risk of delayed ToM development. However, it is unclear whether this is the case for DoH children who receive cochlear implants (CIs) before and around the second year of life. The present study aimed to investigate false belief understanding (FBU) in DoH children with CIs. The relationships between false belief task (FBT) performance, sentence comprehension, age at implantation, duration of CI use, and Speech Recognition Threshold were explored. A total of 94 children with typical levels of hearing (TH) and 45 DoH children (age range: 3-8), who received their first CI between 6 and 27 months of age, were tested on the FBT and a sentence comprehension test. Results showed that 4- and 5-year-old children with CIs performed significantly worse than their peers with TH on the FBT; 6- to 8-year-old children with CIs performed similarly to age-matched children with TH. Age at implantation and duration of CI use were correlated with sentence comprehension but not with the FBT. The results indicated that FBU was delayed until the age of 6 years in most of children with CIs.
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Affiliation(s)
- Agnieszka Pluta
- Correspondence should be addressed to Agnieszka Pluta, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland. E-mail:
| | | | - Małgorzata Zgoda
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Joanna Wysocka
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Karolina Golec
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Joanna Wójcik
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Elżbieta Włodarczyk
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Maciej Haman
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Majorano M, Brondino M, Guerzoni L, Murri A, Ferrari R, Lavelli M, Cuda D, Yoshinaga-Itano C, Morelli M, Persici V. Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation. Am J Audiol 2021; 30:602-615. [PMID: 34139130 DOI: 10.1044/2021_aja-20-00104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study investigates the acoustic environment of children with cochlear implants (CIs) and the relationship between exposure to speech, in noise and in quiet, and the children's lexical production up to 1 year after CI activation, while controlling for the effect of early individual differences in receptive vocabulary growth. Method Eighteen children with CIs were observed at 3, 6, and 12 months after CI activation. Children's spontaneous word production during interaction with their mothers (types and tokens) and their expressive and receptive vocabulary size were considered. The characteristics of the acoustic environments in terms of acoustic scenes (speech in noise or in quiet, quiet, noise, music, and other) and of loudness ranges were assessed using data logging of the children's devices. Results Data analysis showed that both the number of tokens and the number of types produced 1 year after CI activation were affected by the children's exposure to speech in quiet with a loudness range between 40 and 69 dB. Expressive vocabulary size and types were affected by the receptive vocabulary knowledge that the children achieved over the first 3 months after CI activation. Conclusions Our data support the role of speech environment and individual differences in early comprehension on lexical production. The importance of exposure to speech with particular characteristics for the lexical development of children with CIs and the implications for clinical practice are discussed.
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Affiliation(s)
| | | | - Letizia Guerzoni
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | - Alessandra Murri
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | | | | | - Domenico Cuda
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | | | - Marika Morelli
- Department of Human Sciences, University of Verona, Italy
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Glaubitz C, Liebscher T, Hoppe U. Age-related language performance and device use in children with very early bilateral cochlear implantation. Int J Pediatr Otorhinolaryngol 2021; 147:110780. [PMID: 34052573 DOI: 10.1016/j.ijporl.2021.110780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/21/2021] [Accepted: 05/17/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Paediatric cochlear implantation within the first year of life results in better outcome in auditory and language skills. Beside individual, audiological and social factors, quantity and quality of daily cochlear implant (CI) use also seem to be an influencing factor. The purpose of this study was to evaluate children's early receptive and expressive language performance considering bilingual language development as well as quantity and quality of daily CI use and intraoperative objective measurements. METHODS The retrospective analysis included data from 35 very early bilaterally cochlear-implanted children (age at CI M = 8.4 ± 1.5 months). Language performance was assessed by the German standardised test SETK-2 (age at testing M = 29.4 ± 4.0 months). The CI system-integrated data-logging was analysed with regard to daily CoilOn-time, CoilOff and exposure to classified listening scenes. Intraoperatively measured thresholds of evoked compound action potentials (T-ECAPs) were analysed to ensure CI functionality. RESULTS The cohort showed language performance within the normal range for word comprehension, sentence comprehension and word production, level of sentence production was reduced. Overall, bilingual children performed less well than monolingual children. Intraoperative T-ECAPs were recorded for the total cohort and no anomalies were detected. Children used their CI for about 8.7 ± 1.4 h per day, most of this time spent in a quiet environment (38%). Word production was significantly correlated with the daily duration of CI use (CoilOn-time) and with exposure to the listening environment Speech. No correlation was found between number of daily coil disconnections (CoilOff) and language performance. CONCLUSION Very early bilateral cochlear implantation may result in age-appropriate language skills already at the age of 2 years. Monolingualism seems to a better condition for early language development with CI than bilingualism. Especially for word production, the daily duration of CI use and exposure time in a speech-characterised environment seem to be additional positive factors. Monitoring the data-logs should be one important focus of professionals during the postoperative rehabilitation process to detect potential benefits and risks. These findings should be integrated into rehabilitative therapy and parent counselling.
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Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years. Ear Hear 2021; 43:220-233. [PMID: 34260435 PMCID: PMC8694252 DOI: 10.1097/aud.0000000000001092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes.
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Deficient sensory and cognitive processing in children with cochlear implants: An event-related potential study. Hear Res 2021; 408:108295. [PMID: 34175588 DOI: 10.1016/j.heares.2021.108295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 01/16/2023]
Abstract
Compared with children having normal hearing (NH), those with cochlear implants (CIs) perform poorly in spoken language comprehension which involves both low-level acoustic encoding and higher-level cognitive processing. Here, we performed an electroencephalography study to portray this brain dynamics of speech perception in CI children. We presented a Mandarin Chinese monosyllable or four-syllable idiom to CI and NH children, and infrequently varied its lexical tone to form a novel monosyllable or pseudo-idiom in an oddball paradigm. The tone contrast embedded in the monosyllables evoked similar mismatch negativities (MMNs) in CI and NH children at an early stage (~200 ms). However, the amplitude of the MMN evoked by the tone contrast in the idiom context was significantly lower in CI children than in NH children. Furthermore, robust late discriminative negativity (LDN) at a late stage (~500 ms) was found only in NH children, but not in CI children. The MMN and LDN findings indicate deficits of low-level acoustic encoding in a complex context (such as an idiom) and higher-level cognitive processing in CI children, respectively. Both deficient sensory and cognitive processing may contribute to the speech perception difficulties in CI children.
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Chweya CM, May MM, DeJong MD, Baas BS, Lohse CM, Driscoll CLW, Carlson ML. Language and Audiological Outcomes Among Infants Implanted Before 9 and 12 Months of Age Versus Older Children: A Continuum of Benefit Associated With Cochlear Implantation at Successively Younger Ages. Otol Neurotol 2021; 42:686-693. [PMID: 33710159 DOI: 10.1097/mao.0000000000003011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare language and audiological outcomes among infants (<9 and <12 mo) and older children receiving cochlear implantation (CI). STUDY DESIGN Retrospective chart review. SETTING Tertiary academic referral center. PATIENTS Pediatric patients receiving CI between October 1995 and October 2019. INTERVENTION Cochlear implantation. MAIN OUTCOME MEASURES Most recent language and audiological assessment scores were evaluated by age group. RESULTS A total of 118 children were studied, including 19 who were implanted <9 months of age, 19 implanted 9 to <12 months of age, and 80 implanted 12 to <36 months of age. The mean duration of follow-up was 7.4 ± 5.0 years. Most recent REEL-3 receptive (88 ± 12 vs. 73 ± 15; p = 0.020) and expressive (95 ± 13 vs. 79 ± 12; p = 0.013) communication scores were significantly higher in the <9 months group compared to the 9 to <12 months group. PLS and OWLS auditory comprehension and oral expression scores were significantly higher in the <12 months group compared to the 12 to <36 months group. The difference in NU-CHIPS scores between <12 and 12 to <36 months was statistically significant (89% ± 6 vs. 83% ± 12; p = 0.009). LNT scores differed significantly between <9 and 9 to <12 months (94% ± 4 vs. 86% ± 10; p = 0.028). CONCLUSIONS The recent FDA expansion of pediatric CI eligibility criteria to include infants as young as 9 months of age should not serve as a strict clinical cutoff. Rather, CI can be pursued in appropriately selected younger infants to optimize language and audiological outcomes.
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Affiliation(s)
| | | | | | | | - Christine M Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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Percy-Smith L, Wischmann S, Josvassen JL, Schiøth C, Cayé-Thomasen P. Language Development for the New Generation of Children with Hearing Impairment. J Clin Med 2021; 10:2350. [PMID: 34071954 PMCID: PMC8198254 DOI: 10.3390/jcm10112350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances. AIM Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. METHOD AND MATERIAL The project design was prospective, longitudinal, and comparative. Level of receptive vocabulary was compared to children with normal hearing, type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being, and start age for use of hearing technology. A total of 231 children participated. Intervention included early start of hearing technology and three years of auditory-verbal therapy (AVT) at the preschool level, followed by 3 years of AV guidance at the school level. RESULTS Children with HI scored within the norm for receptive vocabulary but were outperformed by the control group. Children with HI and a diagnosed additional disability scored lower than children without additional disability, in terms of parental assessments of social well-being. Children with additional disabilities showed positive progression in terms of receptive vocabulary development. CONCLUSIONS New generations with HI possess the potential to succeed academically in accordance with individual abilities and become active participants in the working market.
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Affiliation(s)
- Lone Percy-Smith
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark;
- Patient Organisation, Decibel, DK-2100 Copenhagen, Denmark; (S.W.); (J.L.J.); (C.S.)
| | - Signe Wischmann
- Patient Organisation, Decibel, DK-2100 Copenhagen, Denmark; (S.W.); (J.L.J.); (C.S.)
| | - Jane Lignel Josvassen
- Patient Organisation, Decibel, DK-2100 Copenhagen, Denmark; (S.W.); (J.L.J.); (C.S.)
| | - Christina Schiøth
- Patient Organisation, Decibel, DK-2100 Copenhagen, Denmark; (S.W.); (J.L.J.); (C.S.)
| | - Per Cayé-Thomasen
- Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark;
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Hall ML. The Input Matters: Assessing Cumulative Language Access in Deaf and Hard of Hearing Individuals and Populations. Front Psychol 2020; 11:1407. [PMID: 32636790 PMCID: PMC7319016 DOI: 10.3389/fpsyg.2020.01407] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/26/2020] [Indexed: 11/13/2022] Open
Abstract
Deaf and hard-of-hearing (DHH) children present several challenges to traditional methods of language assessment, and yet language assessment for this population is absolutely essential for optimizing their developmental potential. Whereas assessment often focuses on language outcomes, this Conceptual Analysis argues that assessing cumulative language input is critically important both in clinical work with DHH individuals and in research/public health contexts concerned with DHH populations. At the individual level, paying attention to the input (and the person's access to it) is vital for discriminating disorder from delay, and for setting goals and strategies for reaching them. At the population level, understanding relationships between cumulative language input and resulting language outcomes is essential to the broader public health efforts aimed at identifying strategies to improve outcomes in DHH populations and to theoretical efforts to understand the role that language plays in child development. Unfortunately, several factors jointly result in DHH children's input being under-described at both individual and population levels: for example, overly simplistic ways of classifying input, and the lack of tools for assessing input more thoroughly. To address these limitations, this Conceptual Analysis proposes a new way of characterizing a DHH child's cumulative experience with input, and outlines the features that a tool would need to have in order to measure this alternative construct.
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Affiliation(s)
- Matthew L Hall
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, United States
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